Treating the wounds that linger

May 25, 2003|By Shia Kapos. Shia Kapos is a Tribune staff reporter.

Soldiers suffered "cardia heart" after the Civil War. During the Great Wars, it was shell shock and combat fatigue. Vietnam and the 1991 gulf war brought post-traumatic stress disorder and gulf war syndrome.

Now, with the war won in Iraq, the American medical and scientific communities are bracing for the invisible baggage U.S. soldiers will carry home.

"Stress from combat has always taken some toll in every war since anyone has documented it," said Arthur Caplan, director of the Center for Bioethics at the University of Pennsylvania School of Medicine.

He and others who have studied the controversial and ill-defined disease known as gulf war syndrome--characterized by an array of symptoms from fatigue and headaches to nausea and rashes--say it still is unknown what illnesses, if any, soldiers might bring home with them.

Officials at the Departments of Defense and Veterans Affairs say they are ready for whatever comes up.

"There are no ironclad assurances that we've thought of everything," Leo Mackay, deputy secretary of veterans affairs, said during a recent visit to Chicago, "but collaboration [with the military] has allowed us to handle any situation that arises."

That wasn't the case in the early 1990s, when both agencies acknowledged that they didn't properly prepare soldiers for the health effects that may have resulted from the first gulf war. So they were determined to be ready this time.

The soldiers have been poked with improved vaccines, clothed in high-tech suits and housed in tents that can withstand a chemical attack, said Lt. Gen. James Peake of the U.S. Army Medical Command. "In Desert Shield, we were using equipment that dated back to post-Korea," he said of the medical equipment teams that have followed forces through the desert.

Soldiers also have filled out detailed health reports and have taken blood tests so doctors can have a baseline to better understand what soldiers' health was like before they went to the Persian Gulf region.

None of that happened before the first gulf war, and some scientists wonder whether still more should have been done this time around.

It was a few years after soldiers returned from the 1991 gulf war--many complaining about rashes, crippling fatigue and memory loss--that the government acknowledged there could be a link between the symptoms and exposure to low-level chemicals during the war.

The United States has since spent more than $200 million trying to try to understand what caused those symptoms.

"We are still trying to unravel the mysteries of gulf war illness," Mackay said. "But what's important is that we have a heightened awareness on the issue" in this gulf war.

The problem, some scientists say, is that there is no single cause to explain gulf war veterans' range of illnesses.

"In the first gulf war, there were a whole slew of challenges that the troops could have been exposed to," Caplan said, listing dust, oil fires, depleted uranium, ticks, insecticides to fight the ticks and even the water. On top of that, he added, there was the possibility of exposure to chemical weapons deployed or stored throughout the country.

"We know there are lots of sick people but we don't know why," he said, adding that soldiers in the gulf today face the same risks.

But researchers say improved technology--from the high-tech gas masks to impenetrable suits--is likely to prevent exposure to such agents from affecting soldiers.

"The government has taken better precautions not to bomb sites that they think might be storing chemical nerve gas, so they haven't released any into the air to expose our troops," said Dr. Robert Haley, professor of internal medicine and epidemiology at the University of Texas Southwestern Medical Center.

Such reassurances didn't stop Donna Steele from worrying about the soldiers she watched on television every day of the latest war.

Her husband, Dan, returned from the first gulf war with a broken leg he suffered when he was hit by a Humvee.

But he soon developed debilitating headaches, respiratory problems, bronchitis, pneumonia and "the red rash."

Doctors initially didn't know what was wrong. But by the time the 37-year-old Army veteran died in 1999, his doctor identified the illness as gulf war syndrome.

As she watched the soldiers' faces on TV, Donna Steele said she wondered what ailment they would bring home this time.